Provider Demographics
NPI:1346041068
Name:BRYDGES, MICHAEL ERIC LEONG
Entity type:Individual
Prefix:
First Name:MICHAEL ERIC
Middle Name:LEONG
Last Name:BRYDGES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6784 PIERCE CT
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-6223
Mailing Address - Country:US
Mailing Address - Phone:909-261-4547
Mailing Address - Fax:
Practice Address - Street 1:6784 PIERCE CT
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-6223
Practice Address - Country:US
Practice Address - Phone:909-261-4547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer